Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0023467 (acute myeloid leukemia)
 35,200 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Three sequential trials of treatment for acute myelogenous leukemia (AML) involving 173 patients were analyzed to identify clinical and myeloblast-cell progenitor properties in culture related to outcome. The latter, including self-renewal capacity expressed as plating efficiency (PE2) and drug sensitivity, were determined for a representative group of 45 patients. Despite increasingly intensive remission induction therapy, similar response rates were achieved in the three trials and no increase in the duration of survival was observed. Clinical attributes at presentation by multivariate analyses were not consistently predictable of outcome. Of the blast cell attributes, only PE2 was predictive of duration of survival (p less than 10(-6)). For patients in remission the relapse rate during the first year was 0.63 compared with 0.15 in subsequent years. The percentage marrow myeloblasts at presentation, a measure of disease activity, was significantly higher for the patients having remissions lasting less than one year. These studies demonstrate the importance of disease-related attributes on the outcome of patients with AML.
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PMID:Contributions of host- and disease-related attributes to the outcome of patients with acute myelogenous leukemia. 636 58

We have investigated the self-renewal capacity (PE2) and in vitro sensitivity to cytosine-arabinoside (ara-C) and daunorubicine (DNR) of leukemic progenitors (CFU-AML) to determine the significance of these tests for predicting induction treatment outcome in 75 adult acute myeloid leukemia (AML) patients. In addition, in a part of this group of patients (n = 46) we determined the expression of P-glycoprotein (P-gp) immunocytochemically and correlated those results with the therapeutic response. We have evaluated 66 patients who showed the following responses: 28/66 complete remissions (CR), 16/66 resistant leukemias (RL) and 22/66 early deaths (ED). The PE2 value was significantly higher in patients with RL than in patients with CR (p < 0.00375). CFU-AML sensitivity to ara-C and DNR alone was not different between response groups, but the difference in CFU-AML sensitivity to the combination of drugs between patients with CR and RL was not significant, although a trend was noted (p < 0.06). P-gp expression was found in only 1/18 patients who achieved CR but in 9/11 patients with RL and 7/11 patients with ED, which is a highly significant difference (p < 0.0006). We concluded that both PE2 and P-gp expression in AML cells are valuable predictors of therapeutic response in adult AML and should be included in creating the best therapeutic approach to AML patients.
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PMID:In vitro drug sensitivity of leukemic progenitors and P-glycoprotein expression in adult acute myeloid leukemia: correlation with induction treatment outcome. 762 94

The effects of vesnarinone (3,4-dihydro-6-[4(3,4-dimethoxybenzoyl)-1-piperanizyl]-2 (1H)-quinolinone) on the hematopoietic precursors in 5 healthy volunteers and leukemic blast progenitors in 11 acute myeloid leukemia (AML) patients, 1 chronic myelocytic leukemia patient (CML) in blast crisis, and 3 leukemic cell lines were studied in methylcellulose and suspension cultures. Normal erythroid precursors (colony-forming unit erythroid: CFU-E and burst-forming unit erythroid: BFU-E) and granulopoietic precursors (colony-forming unit granulocyte/macrophage: CFU-GM) were suppressed in methylcellulose culture by vesnarinone in a dose-dependent manner. Leukemic blast progenitors may replicate themselves and/or undergo terminal divisions with limited differentiation. The plating efficiency of primary blast colony formation (PE1) in methylcellulose, which is considered to reflect the terminal divisions of leukemic blast progenitors, was suppressed by vesnarinone in a dose-dependent manner in all cases tested. The plating efficiency of secondary blast colony-formation (PE2) in methylcellulose culture and the recovery of clonogenic cells in the suspension culture, which are considered to reflect the self-replication function of leukemic blast progenitors, were also suppressed by vesnarinone in a dose-dependent manner in all cases tested. The results suggest that vesnarinone inhibits the growth of normal and leukemic hematopoietic progenitors. To determine the mechanism by which vesnarinone inhibits hematopoiesis, the effect of the agent on apoptosis (programmed cell death) of leukemic cells was studied. DNA ladder formation was recognized in OCI/AML 1 a cells after exposure to 100 micrograms/ml vesnarinone for 18 hours; this means that vesnarinone induced apoptosis in this cell line. Therefore, vesnarinone is considered to be the cause of apoptosis of granulopoietic precursors.
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PMID:[Suppression of granulopoiesis by vesnarinone]. 872 53

We studied the effects of vesnarinone, a quinolinone derivative used clinically for the treatment of chronic congestive heart failure, on the leukemic blast progenitors in acute myelogenous leukemia (AML) patients and on the normal hematopoietic precursors, colony-forming unit in culture (CFU-C), and colony-forming unit erythroid (CFU-E). Leukemic blast progenitors made blast colonies in the presence of granulocyte-colony stimulating factor (G-CSF), granulocyte-macrophage CSF (GM-CSF), or interleukin-3 (IL-3). Blast colony-formation was suppressed by vesnarinone in a dose-responsive manner regardless of growth factor added. Vesnarinone suppressed the primary (PE1) and secondary (PE2) colony-formation of leukemic blast progenitors in six AML patients tested. The suppression by vesnarinone did not significantly differ between PE1 and PE2. This finding suggests that vesnarinone exerts an almost equivalent effects on the terminal divisions and the self-renewal of leukemic blast progenitors. Furthermore, this drug suppressed the growth of clonogenic cells of five AML cell lines, OCI/AML1a, OCI/AML2, OCI/AML3, OCI/AML5, and OCI/AML6. Normal hematopoietic precursors CFU-C and CFU-E were also suppressed by vesnarinone, although vesnarinone was less toxic to normal hematopoietic than to leukemic blast progenitors. The possible usefulness of vesnarinone as a new approach to the treatment of AML patients is discussed.
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PMID:Effect of vesnarinone, a quinolinone derivative, on the growth of leukemic blasts in acute myelogenous leukemia. 909 Dec 94


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